| NPI | 1194571075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP003180) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A181330) |
| Enumeration Date | 2024-04-30 |
| Last Update Date | 2025-09-09 |